| NPI | 1104658269 |
|---|---|
| Other Name | VIVIAN GAMBINO RUSSO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2024-08-16 |
| Last Update Date | 2025-04-11 |